title: Nodal positivity in breast cancer correlated with the number of lesions detected by magnetic resonance imaging versus mammogram.
abstract: BACKGROUND
  Magnetic resonance imaging (MRI) in breast cancer can detect more than 15% additional lesions than mammography. We investigated lymph node metastases rates in patients with multifocal or multicentric disease detected by MRI compared with patients with a single lesion detected by mammography and magnetic resonance imaging.
  
  
  METHODS
  A retrospective analysis of breast cancer patients undergoing MRI and mammography was performed. The objective was to compare lymph node metastases rates in patients with additional lesions detected by MRI versus a single lesion detected by mammography or MRI.
  
  
  RESULTS
  Of 413 patients, 318 were included for the study. The overall nodal metastases rate was 24.8%. MRI detected multiple lesions in 83 (26.1%) patients; 67 (21.1%) patient MRI findings were not detected by mammography. The lymph node metastases rate was 37.3% when ≥ 2 lesions were detected compared with 20.2% when a single malignant lesion was detected (P = .01). The evaluation of the 67 patients with additional lesions detected by MRI revealed 32 patients with invasive lesions, 29 with benign lesions, and 6 with in situ disease. Comparing patients with single malignant lesions with patients with additional malignant lesions detected by MRI, the lymph node metastases rate increased from 20.2% to 50% (P = .002).
  
  
  CONCLUSIONS
  Our study shows a significant increase in the lymph node metastases rate in patients with additional malignant lesions detected by MRI. This finding suggests that MRI-detected malignant lesions are biologically significant and may predict more aggressive disease.
authors.affiliation: Department of Surgical Oncology, Michigan State University, Regional Medical Imaging, Flint, MI 48532-3685, USA. ssahadr@aol.com
authors.forename: Sukamal
authors.initials: S
authors.lastname: Saha
authors.forename: Saad
authors.initials: S
authors.lastname: Sirop
authors.forename: Alpesh
authors.initials: A
authors.lastname: Korant
authors.forename: Mohammed
authors.initials: M
authors.lastname: Kanaan
authors.forename: Rohil
authors.initials: R
authors.lastname: Shekher
authors.forename: David
authors.initials: D
authors.lastname: Strahle
authors.forename: Michael
authors.initials: M
authors.lastname: Hicks
authors.forename: Randy
authors.initials: R
authors.lastname: Hicks
authors.forename: Linda
authors.initials: L
authors.lastname: Lawrence
authors.forename: David
authors.initials: D
authors.lastname: Wiese
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008327:Mammography; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors